Wang Chunxiu, Fang Xianghua, Hua Yang, Liu Yutong, Zhang Zhongying, Gu Xiang, Wu Xiaoguang, Tang Zhe, Guan Shaochen, Liu Hongjun, Liu Beibei, Guo Xiuhai, Ji Xunming
1 Department of Evidence-based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
2 Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China.
Angiology. 2018 Jan;69(1):49-58. doi: 10.1177/0003319717704554. Epub 2017 Apr 21.
We explored the associations between lipoprotein-associated phospholipase A2 (Lp-PLA2) level and carotid atherosclerosis with all phenotypes and cardiovascular disease (CVD) events in Chinese older adults. A total of 1257 adults aged ≥55 years who were free of CVD were enrolled in this cohort study. Lipoprotein-associated phospholipase A2 level was evaluated in 3 categories: Lp-PLA2 < 175, 175≤ Lp-PLA2 < 223, and Lp-PLA2 ≥ 223 ng/mL. The highest level of Lp-PLA2 was independently associated with common carotid artery intima-media thickening (≥1.0 mm; odds ratio [OR]: 1.60, 95% confidence interval [CI]: 1.14-2.26) and carotid plaque (OR: 1.42, 95% CI: 1.01-1.99) in individuals without carotid artery stenosis. At the end of the 5-year follow-up, after adjustment for CVD risk factors and carotid atherosclerosis status, Lp-PLA2 had remained an independent predictor for myocardial infarction (MI; hazard ratio [HR]: 1.90, 95% CI: 1.02-3.55) and CVD death (HR: 1.78, 95% CI: 1.02-3.13). However, no association was found with stroke. Therefore, elevated Lp-PLA2 level in the older adults studied was associated with an increased risk of carotid atherosclerosis and MI and CVD mortality. Lipoprotein-associated phospholipase A2 assessment might be used for MI and CVD death risk prediction.
我们探讨了中国老年人群中脂蛋白相关磷脂酶A2（Lp-PLA2）水平与具有所有表型的颈动脉粥样硬化及心血管疾病（CVD）事件之间的关联。本队列研究共纳入了1257名年龄≥55岁且无CVD的成年人。Lp-PLA2水平分为3类进行评估：Lp-PLA2<175、175≤Lp-PLA2<223和Lp-PLA2≥223 ng/mL。在无颈动脉狭窄的个体中，Lp-PLA2的最高水平与颈总动脉内膜中层增厚（≥1.0 mm；比值比[OR]：1.60，95%置信区间[CI]：1.14 - 2.26）和颈动脉斑块（OR：1.42，95%CI：1.01 - 1.99）独立相关。在5年随访结束时，在对CVD危险因素和颈动脉粥样硬化状态进行调整后，Lp-PLA2仍然是心肌梗死（MI；风险比[HR]：1.90，95%CI：1.02 - 3.55）和CVD死亡（HR：1.78，95%CI：1.02 - 3.13）的独立预测因子。然而，未发现与卒中有关联。因此，在所研究的老年人群中，Lp-PLA2水平升高与颈动脉粥样硬化、MI及CVD死亡率增加的风险相关。脂蛋白相关磷脂酶A2评估可用于MI和CVD死亡风险预测。
